Hydrocephalus complicating a cervical spine fracture in a patient with ankylosing spondylitis

Challagundla, Sudhakar Rao; Joseph, Gregory J.; Brown, Jennifer I.; McLean, Andrew N.; Fraser, Matthew

doi:10.1080/02688690801969489

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…Spreading of spinal cord edema as high as the medulla oblongata after a cervical SCI has also been reported10). Challagundla et al1) reported on a case of hydrocephalus following fracture dislocation of C5-6 in a patient with ankylosing spondylitis. He postulated that hydrocephalus resulted from obstruction of CSF flow at the fourth ventricular outlets due to ascending edema of the medulla oblongata from the cervical spine.…”

Section: Discussionmentioning

confidence: 88%

Acute Hydrocephalus Following Cervical Spinal Cord Injury

Son

Lee

Park

et al. 2013

J Korean Neurosurg Soc

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We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drowsiness with dilatation of the right pupil. Findings on brain computed tomography revealed acute hydrocephalus and subarachnoid hemorrhage in the cerebellomedullary cistern, therefore, extraventricular drainage was performed immediately. Acute hydrocephalus as a complication of cervical spine trauma is rare, however, it should be considered if the patient shows deterioration of neurologic symptoms.

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Section: Discussionmentioning

confidence: 88%

Acute Hydrocephalus Following Cervical Spinal Cord Injury

Son

Lee

Park

et al. 2013

J Korean Neurosurg Soc

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“…Yablon et al10) suggested that the swelling of the spinal cord, observed after spinal trauma, may extend up to two vertebral segments above and below the injured vertebrae. Challagundla et al1) reported a case of hydrocephalus following fracture dislocation of C5-6 in a patient with ankylosing spondylitis. He postulated that hydrocephalus resulted from the obstruction of CSF flow at the fourth ventricular outlets due to the ascending edema of the medulla oblongata from the cervical spine.…”

Section: Discussionmentioning

confidence: 99%

Acute Hydrocephalus as a Complication of Cervical Spine Fracture and Dislocation: A Case Report

Chung

Kim

et al. 2014

Korean J Spine

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Hydrocephalus is a well-known complication of head injury, but an uncommon complication of a spinal lesion. Here, we present a rare case of acute obstructive hydrocephalus secondary to a cervical fracture and dislocation. A 60-year-old female patient was transferred to the emergency department with quadriplegia and respiratory difficulty. Imaging studies showed a cervical fracture and dislocation at the C3-4 level. She required intubation and mechanical ventilation. Twenty-four hours after admission, her mental status had deteriorated and both pupils were dilated. Computed tomography of the brain showed acute hydrocephalus; therefore, extraventricular drainage (EVD) was performed. After the EVD, her mental status recovered and she became alert, but she remained quadriplegic and dependent on the ventilator. Two months after injury, she died because of respiratory failure caused by pneumonia.

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“…A whole-body CT scan performed upon admission of the patient revealed a Type II dens axis fracture4 and serial rib fractures. No other injuries of the head, spine or torso were found.…”

Section: Investigationsmentioning

confidence: 99%

“…Cerebrospinal fluid (CSF) leaks after spine surgery are well documented and are among the most commonly reported complications, occurring in approximately 15% of patients undergoing spine surgery 3. Usually, postoperative leakage of CSF leads to subcutaneous fluid accumulation at the operation site, but has no obstructive effect on liquor circulation, whereas the development of a hydrocephalus after cervical spine fractures, especially in association with pre-existing malformations, malignancies or inflammations, as a complication is known 4. The development of a hydrocephalus communicans (a combined form of hydrocephalus occlusivus and hydrocephalus maleresorbtivus ) after fractures of the upper cervical spine in healthy older patients5 has never been reported to the best of our knowledge.…”

Section: Introductionmentioning

confidence: 99%

Hydrocephalus communicans after traumatic upper cervical spine injury with a cerebrospinal fluid fistula: a rare complication

Mica

Neuhaus²,

Poschmann³

et al. 2010

Case Reports

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SummarySecondary hydrocephalus communicans after traumatic upper cervical spine injuries with leakage of cerebrospinal fluid is a rare and hardly described complication. A case of a 75-year-old woman sustained a type II dens axis without other injuries, especially without evidence of a hydrocephalus in the primary CT scan. Dorsal atlanto-axial fusion was performed. Postoperative drainage was prolonged and positive for β2-transferrin. Wound revision with an attempt to seal the leakage was not successful. Secondary CT scans of the brain were performed due to neurological deterioration and showed a hydrocephalus with typical EEG findings. No anatomical reason for a circulative obstruction was found in the CT scan. After application of a ventriculo-peritoneal shunt the neurological status improved and the patient could be discharged to neurological rehabilitation.

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Hydrocephalus complicating a cervical spine fracture in a patient with ankylosing spondylitis

Cited by 6 publications

References 3 publications

Acute Hydrocephalus Following Cervical Spinal Cord Injury

Acute Hydrocephalus Following Cervical Spinal Cord Injury

Acute Hydrocephalus as a Complication of Cervical Spine Fracture and Dislocation: A Case Report

Hydrocephalus communicans after traumatic upper cervical spine injury with a cerebrospinal fluid fistula: a rare complication

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